Mitze v. Colvin: Social Security Disability Appeals Process

Mitze v. Colvin, an appeal from the United States Court of Appeals for the Seventh Circuit, involved claimant who applied for Social Security Disability Insurance (SSDI) benefits in 2009 at the age of 43 because she was suffering from a cyst in her pineal gland. The pineal gland is a small endocrine gland in the human brain which is responsible for production of melatonin. Melatonin is necessary to regulate sleep.

After Social Security Administration (SSA) denied her initial application, and she made several efforts to apply for reconsideration in writing, SSA granted her a hearing before an administrative law judge (ALJ) in November of 2011. ALJ held a hearing and rejected her claim for disability benefits. At this point, claimant appealed to the district court. During this appeal, the court affirmed ALJ’s denial of benefits.

The problem with finding claimant disabled, according to ALJ and district court, is pineal cysts are typically harmless. However, this is not always true. In this case, claimant testified her cyst caused blurred vision, headaches and vertigo, and these symptoms made it impossible for her to work in a full-time capacity.
As part of her treatment, claimant underwent brain surgery in 2010 to remove the cyst. Following surgery, doctors ordered an MRI showing the cyst was removed, and she was healing normally. Claimant’s vertigo and blurred vision also resolved following surgery. However, claimant testified within a few weeks of surgery, she began experiencing both pain and numbness in her head. Her doctor referred her to an anesthesiologist who prescribed drugs and also gave her a referral to two pain specialists.

One of these pain management specialists recommended claimant undergo an occipital nerve injection. This is considered a standard pain management technique involving an injection in the back of the head. Claimant decided not to undergo this procedure. Claimant opted not to see the other pain management specialist. Claimant’s anesthesiologist gave her the name of a third pain management specialist who recommended some type of higher level of specialized care at a hospital, and she declined, saying she was unable to travel to the hospital on a regular basis, as it was two hours from her home.

There was also testimony claimant was training for a marathon during her treatment, though she did not actually end up running the race. She instead chose to run a 5,000 meter race and went to Australia for a month.

Ultimately, based upon claimant’s refusal to undergo recommended treatment for her medical condition, and engaging in other activities such as training to run a marathon and traveling long distances on vacation, the courts concluded she was likely to be “dramatizing” the severity of her symptoms for the purpose of obtaining Social Security disability benefits and affirmed ALJ and lower court’s denial of benefits.

As our Boston Social Security disability lawyers can explain, it is important to present the best possible case for obtaining disability benefits as early in the process as possible. Though there are several levels of appeals and hearings, if your initial application has been denied, the sooner in the process you speak with an experienced attorney, the better your chances will be of obtaining a favorable outcome.

Call the Law Offices of Jeffrey S. Glassman for a free and confidential appointment — 1-888-367-2900.

Additional Resources:

Mitze v. Colvin, April 11, 2015, United States Court of Appeals for the Seventh Circuit
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